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General NPI Number Information
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NPI Number | 1184647059
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Entity Type | Organization
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Legal Business Name | CALIFORNIA EMERGENCY PHYSICIANS MEDICAL GROUP
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 8833 MONTEREY RD SUITE H
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City | GILROY
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State | CA
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Zip | 95020
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Country | US
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Telephone | 408-842-1544
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Fax |
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Provider Business Mailing Address
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Address Line | 1601 CUMMINS DR STE D
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City | MODESTO
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State | CA
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Zip | 95358-6411
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Country | US
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Telephone | 510-851-7423
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Fax |
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Authorized Official
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Title or Position | COO
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Name | THEOPHILE KOURY
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Credential | M.D.
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Telephone | 510-350-2770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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